A major new international study has found that children born to mothers with diabetes are significantly more likely to develop neurodevelopmental conditions such as autism, ADHD, and intellectual disabilities.
The findings, published in The Lancet Diabetes & Endocrinology, are based on data from over 56 million pregnancies and highlight the urgent need for better prenatal monitoring and maternal health support.
The study, led by researchers from Central South University in China, is the largest of its kind to date, involving a meta-analysis of 202 previous studies that collectively examined more than 56.1 million mother-child pairs.
The researchers concluded that maternal diabetes, whether pre-existing or gestational, is associated with a higher risk of a wide range of neurodevelopmental disorders in children.
Compared to children of non-diabetic mothers, children whose mothers had diabetes during pregnancy were found to have a 28% increased risk of being diagnosed with a neurodevelopmental disorder.
This includes a 25 per cent higher risk of autism spectrum disorder (ASD), a 30 per cent higher risk of attention-deficit/hyperactivity disorder (ADHD), and a 32 per cent higher risk of intellectual disabilities.
Beyond autism and ADHD, the study also found elevated risks for other developmental challenges as children exposed to maternal diabetes were 20 per cent more likely to have communication difficulties, while 17 per cent are more likely to have motor skill issues, and 16 per cent more likely to suffer from learning disorders.
The risks were particularly pronounced in mothers who had pre-existing diabetes, also known as pre-gestational diabetes, which appeared to raise the risk of neurodevelopmental disorders by 39 per cent, compared to gestational diabetes that develops during pregnancy and often resolves after childbirth.
A GROWING HEALTH CONCERN
The findings come amid rising global rates of diabetes in pregnancy as according to the U.S. Centers for Disease Control and Prevention (CDC), diabetes affects up to 9 per cent of pregnancies in the United States.
Globally, the prevalence of gestational diabetes is estimated to be between 14 per cent and 27 per cent, driven largely by increasing obesity rates and metabolic syndrome, a cluster of conditions that includes high blood sugar, excess abdominal fat, and abnormal cholesterol levels.
The International Diabetes Federation reported that in 2021 alone, 17 million live births occurred in women who had gestational diabetes.
Although the link between maternal diabetes and child neurodevelopment is strong, the study stops short of proving a direct cause.
Seven of the studies analysed compared affected children to their own siblings and found no clear differences, suggesting that other shared genetic or familial factors may also contribute to the elevated risk.
However, the consensus among researchers is that maternal diabetes can influence fetal brain development as past studies have shown that high maternal blood sugar levels can disrupt how the brain grows in utero, potentially leading to long-term cognitive and behavioral consequences.
EXPERT PERPECTIVES ON THE FINDINGS
NYU Grossman School of Medicine associate professor, Dr. Magdalena Janecka, who was not involved in the study but specializes in child development and prenatal exposure, commented on the broader implications of the findings.
"Meta-analyses allow us to compare groups more precisely.
"At the same time, they are not bringing us any closer to understanding the causes or the underlying mechanisms,” Janecka said.
Professor Lucilla Poston, another expert who reviewed the study, agreed that while the study offers valuable insights, it must be interpreted with caution.
"While the conclusion is that children born to mothers with diabetes are at risk of neurodevelopmental disorders, all contributing studies were observational, with no attempt to intervene to prevent any effect, and causality must be treated with caution,” Poston said.
PREVENTION AND MONITORING ARE KEY
Despite the lack of definitive causal proof, the study’s authors emphasize the importance of proactive medical interventions.
Monitoring and managing maternal blood sugar levels during pregnancy, especially for women already at risk of diabetes, could potentially reduce these developmental risks.
"These findings underscore the importance of proactive interventions for women at risk of developing diabetes and highlight the need for continued monitoring of children with a history of in-utero exposure to maternal diabetes,” the researchers stated.
The team also noted that this is the first meta-analysis to evaluate and compare outcomes in children exposed to different types of maternal diabetes, adding much-needed clarity to a topic that has significant implications for maternal and child health worldwide.
This large-scale study offers compelling evidence of a link between maternal diabetes and a host of neurodevelopmental issues in children.
While it does not definitively establish cause and effect, it strongly supports the need for early screening, better diabetes management during pregnancy, and long-term follow-up care for children who may be at risk.
With diabetes in pregnancy becoming increasingly common, the message from experts is clear, maternal health plays a crucial role in shaping the lifelong neurological and cognitive outcomes of the next generation.
The findings, published in The Lancet Diabetes & Endocrinology, are based on data from over 56 million pregnancies and highlight the urgent need for better prenatal monitoring and maternal health support.
The study, led by researchers from Central South University in China, is the largest of its kind to date, involving a meta-analysis of 202 previous studies that collectively examined more than 56.1 million mother-child pairs.
The researchers concluded that maternal diabetes, whether pre-existing or gestational, is associated with a higher risk of a wide range of neurodevelopmental disorders in children.
Compared to children of non-diabetic mothers, children whose mothers had diabetes during pregnancy were found to have a 28% increased risk of being diagnosed with a neurodevelopmental disorder.
This includes a 25 per cent higher risk of autism spectrum disorder (ASD), a 30 per cent higher risk of attention-deficit/hyperactivity disorder (ADHD), and a 32 per cent higher risk of intellectual disabilities.
Beyond autism and ADHD, the study also found elevated risks for other developmental challenges as children exposed to maternal diabetes were 20 per cent more likely to have communication difficulties, while 17 per cent are more likely to have motor skill issues, and 16 per cent more likely to suffer from learning disorders.
The risks were particularly pronounced in mothers who had pre-existing diabetes, also known as pre-gestational diabetes, which appeared to raise the risk of neurodevelopmental disorders by 39 per cent, compared to gestational diabetes that develops during pregnancy and often resolves after childbirth.
A GROWING HEALTH CONCERN
The findings come amid rising global rates of diabetes in pregnancy as according to the U.S. Centers for Disease Control and Prevention (CDC), diabetes affects up to 9 per cent of pregnancies in the United States.
Globally, the prevalence of gestational diabetes is estimated to be between 14 per cent and 27 per cent, driven largely by increasing obesity rates and metabolic syndrome, a cluster of conditions that includes high blood sugar, excess abdominal fat, and abnormal cholesterol levels.
The International Diabetes Federation reported that in 2021 alone, 17 million live births occurred in women who had gestational diabetes.
Although the link between maternal diabetes and child neurodevelopment is strong, the study stops short of proving a direct cause.
Seven of the studies analysed compared affected children to their own siblings and found no clear differences, suggesting that other shared genetic or familial factors may also contribute to the elevated risk.
However, the consensus among researchers is that maternal diabetes can influence fetal brain development as past studies have shown that high maternal blood sugar levels can disrupt how the brain grows in utero, potentially leading to long-term cognitive and behavioral consequences.
EXPERT PERPECTIVES ON THE FINDINGS
NYU Grossman School of Medicine associate professor, Dr. Magdalena Janecka, who was not involved in the study but specializes in child development and prenatal exposure, commented on the broader implications of the findings.
"Meta-analyses allow us to compare groups more precisely.
"At the same time, they are not bringing us any closer to understanding the causes or the underlying mechanisms,” Janecka said.
Professor Lucilla Poston, another expert who reviewed the study, agreed that while the study offers valuable insights, it must be interpreted with caution.
"While the conclusion is that children born to mothers with diabetes are at risk of neurodevelopmental disorders, all contributing studies were observational, with no attempt to intervene to prevent any effect, and causality must be treated with caution,” Poston said.
PREVENTION AND MONITORING ARE KEY
Despite the lack of definitive causal proof, the study’s authors emphasize the importance of proactive medical interventions.
Monitoring and managing maternal blood sugar levels during pregnancy, especially for women already at risk of diabetes, could potentially reduce these developmental risks.
"These findings underscore the importance of proactive interventions for women at risk of developing diabetes and highlight the need for continued monitoring of children with a history of in-utero exposure to maternal diabetes,” the researchers stated.
The team also noted that this is the first meta-analysis to evaluate and compare outcomes in children exposed to different types of maternal diabetes, adding much-needed clarity to a topic that has significant implications for maternal and child health worldwide.
This large-scale study offers compelling evidence of a link between maternal diabetes and a host of neurodevelopmental issues in children.
While it does not definitively establish cause and effect, it strongly supports the need for early screening, better diabetes management during pregnancy, and long-term follow-up care for children who may be at risk.
With diabetes in pregnancy becoming increasingly common, the message from experts is clear, maternal health plays a crucial role in shaping the lifelong neurological and cognitive outcomes of the next generation.